The Yukon-Kuskokwim Women's Cancer Control Project will test an intervention provided by the Yukon-Kuskokwim Health Corporation (YKHC) based on techniques of Continuous Quality Improvement (CQI) to increase indicated cancer early detection and prevention services for Native Alaskan women. The intervention builds on the Community Health Aide and village clinic system to better understand culturally appropriate needs and expectations of Native Alaskan women and to support active Native health provider participation and leadership in care delivery assessment and improvement Specifically, the CQI approach will build on the culturally sensitive knowledge and skills of Community Health Aides to develop a management process in each village clinic that empowers and activates both community women and Health Aides to achieve better cancer early detection and prevention services. The target group for behavior change is Alaska Native women age 18 years and over who reside in rural villages outside of the regional administrative center of Bethel, Alaska. Twenty four YKHC village clinics will be assigned randomly to early or late intervention status. Late- intervention communities will serve as controls for purposes of evaluation since the intervention will be provided in these villages after follow-up data are collected. Evaluation will be based on reviews of the medical records for 50 randomly selected women from each village covering the two year period prior to the early intervention and the two years thereafter. This Project will test the hypothesis that a three component intervention directed at Community Health Aide knowledge and skills, culturally appropriate community education and outreach, and an office reminder system in each clinic to monitor patient cancer control needs will increase indicated cervical and breast cancer control services provided in early intervention communities compared to controls. The secondary hypothesis is that for early intervention villages compared to controls Health Aide knowledge and skills will increase. The Project will answer the question "can an intervention supplied by YKHC and based on CQI techniques increase indicated cancer control services in rural Native Alaskan communities over a two-year period?" As a result of this Project the National Cancer Institute and interested intermediaries will have a cancer control enhancing intervention based on CQI of known efficacy and cost when applied in rural Native Alaskan communities.